Surgical rongeurs are well known in the surgical community. The Kerrison-type surgical rongeur is commonly used to cut bone and soft tissue. The Kerrison rongeur typically comprises a stationary shaft and a cutting slide that is longitudinally slidable relative to the stationary shaft. At the distal end of the cutting slide is a cutting edge which engages a foot plate that is located at the distal end of the stationary shaft. The cutting edge on the cutting slide and the foot plate on the stationary shaft are commonly referred to as the “cutting jaws”.
Presently, Kerrison rongeurs include a small cup between the cutting jaws for capturing the cut pieces of bone. However, this cup can only hold a single bone chip. Consequently, the rongeur must be removed from the surgical site after each cut of bone in order to clean out the bone from the cup. To remove the bone from the cup, the surgeon often has his assistant clean out the bone from the cup with a small piece of cloth. However, if the bone is too tightly lodged in the cup, the surgeon relinquishes the rongeur to a scrub nurse who attempts to remove the bone using a knife or other instrument. The removal of the rongeur from the surgical situs and relinquishment of the rongeur to the nurse after each cut of bone greatly increases the amount of time necessary to complete the surgical task.
When the rongeur becomes old, the cutting edge becomes dull. Under these circumstances, the cutting edge is often advanced against the foot plate using force in excess of that necessary to cut the bone. When this occurs, the bone placed between the cutting jaws may become compacted in the cup and very difficult, often impossible, to remove without complete disassembly of the rongeur. The compacted bone, therefore, prevents any subsequent use of the rongeur. Also, the bone is often crushed rather than cut, creating added stress on the cutting jaws of the ronguer.
Also, the cutting edge on the cutting slide becomes dull over time, considerably decreasing the effectiveness of the rongeur. To compensate for the dull cutting edge, surgeons apply increasing force when advancing the cutting edge against the foot plate. This increased force causes the track receiving the cutting slide to stretch, and the cutting slide to thereby move upward against the foot plate. The upward movement of the cutting slide results in very poor cutting.
When the cutting becomes too poor, hospitals routinely send the rongeur to be sharpened. Because rongeurs are less expensive to sharpen than replace, hospitals will almost always first send the rongeur to be sharpened before replacing it. However, sharpening rarely helps the quality of the cutting, and hospitals generally replace the entire rongeur shortly thereafter. Consequently, hospitals typically spend far more to replace an ineffective rongeur than the cost of a new rongeur.
The replacement of the entire rongeur is generally necessary after they have become ineffective because rongeurs are typically constructed as a unitary instrument. However, because a rongeur typically becomes ineffective when the cutting edge becomes dull, only the replacement of the cutting edge is truly necessary. Therefore, a need arises for a rongeur with a removable and replaceable cutting edge.
Accordingly, a need exists for an improved surgical rongeur capable of increased efficiency and decreased expense.